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目的观察风湿性心脏瓣膜病(风心病)心房颤动(房颤)患者心房组织中Ⅰ型胶原和IL-1β基因表达的改变。方法 75例风心病接受换瓣手术者分为窦性心律组(34例)、阵发性房颤组(11例)、持续性房颤组(30例),于术中取右心耳组织,应用半定量 RT-PCR,测定心房组织中Ⅰ型胶原、IL-1β的 mRNA 水平。结果与窦性心律组比较,Ⅰ型胶原的 mRNA 在阵发性房颤患者(P<0.05)、持续性房颤患者(P<0.001)心房组织中的表达均明显增加;持续性房颤患者心房组织中IL-1β的 mRNA 水平明显增加(P<0.05)。IL-1β的 mRNA 水平与Ⅰ型胶原的 mRNA 水平(r=0.295,P=0.011)、左心房内径(r=0.385,P=0.001)、房颤持续时间(r=0.326,P=0.004)呈正相关。结论心房组织中 IL-1β mRNA 转录水平的上调可能是影响胶原代谢,导致房颤患者心房纤维化的分子机制之一,与房颤的发生和维持有关。
Objective To observe the changes of the expression of type Ⅰ collagen and IL-1β in atrial tissue of atrial fibrillation patients with rheumatic heart disease (rheumatic heart disease). Methods Seventy-five patients with rheumatic heart disease undergoing valve replacement surgery were divided into three groups: sinus rhythm group (34 cases), paroxysmal atrial fibrillation group (11 cases) and persistent atrial fibrillation group (30 cases) Application of semi-quantitative RT-PCR, atrial tissue of collagen type Ⅰ, IL-1β mRNA levels. Results Compared with sinus rhythm group, the mRNA expression of type Ⅰ collagen in atrial fibrillation patients (P <0.05) and in patients with persistent atrial fibrillation (P <0.001) were significantly increased. In patients with persistent atrial fibrillation Atrial tissue IL-1β mRNA levels were significantly increased (P <0.05). The mRNA level of IL-1β was positively correlated with the mRNA level of type Ⅰ collagen (r = 0.295, P = 0.011), the diameter of the left atrium (r = 0.385, P = 0.001) and the duration of atrial fibrillation Related. Conclusion The up-regulation of IL-1β mRNA in atrial tissue may be one of the molecular mechanisms that affect collagen metabolism and lead to atrial fibrillation in atrial fibrillation, which is related to the occurrence and maintenance of atrial fibrillation.